The word Shock is used in a special sense in surgery and first aid,
and should not be confused with ordinary, temporary reactions to sudden stimuli.
Bad news and terrifying events can cause momentary confusion and frustration, as
in emotional upsets or they can have more lasting effects, as in the neuro-psychiatric
condition called shell-shock. Injections of drugs can have abrupt effects, like those of
insulin shock. Sudden, brief electric current applied to skin, muscles or nerve are called
electric shock, and can elect more or less vigorous physiological responses.
But when used in surgery and
first aid, shock means a peculiar,
dangerous state in which the blood pressure is so low, the circulation
so inadequate and all the protective reflexes of the body so depressed
that the patient very survival is in doubt.
If the cause of shock is known in a given case it may
be specified in this manner:
is that caused by severe accidental injury.
is associated with great loss of blood.
is an intense allergic reaction.
follows a sudden spread of a severe infection.
Cardiogenic shock: This refers to a state of decreased tissue perfusion that occurs secondary to inadequate pumping function of the heart. This can occur secondary to a heart attack, heart valve disorder (aortic
stenosis), cardiac arrhythmia, or from cardiac de-compensation.
Cardiopulmonary Obstructive shock: This can occur as the result of an "obstruction" of the cardiopulmonary circuit. Examples include massive pulmonary embolism, pericardial
tamponade, pneumothorax, and severe constrictive pericarditis.
Signs & Symptoms of Shock
The first step in properly aiding an accident victim
is to recognize the signs and symptoms of shock. Look for evidence of
weakness due to inadequate circulation: pale skin color,
skin temperature. Take note of victim's face. If he is suffering from
shock, his eyes will be vacant and lackluster, with dilated pupils and
his breathing will be shallow and irregular. Perspiration may appear
above his lips and on his forehead, palms and armpits. Nausea may
accompany signs of restlessness.
The extremities, like the face, will be cold, pale
and moist. His pulse will be wither weak or absent, but if noticeable
will be fast. These signs may not appear at once, especially the irregular
breathing, but may become evident an hour or more after the injury.
Shock is often confused with fainting since simple
or minor injuries may cause a victim to faint.
Sometimes an accident victim, even when severely
injured, will appear alert at first and display no shock symptoms. But
first aid measures should be followed anyway, for in many cases he
will collapse later. Whether or not the victim shows signs or symptoms
of shock, always keep him lying flat and do not allow him to move.
First aid measures apply to both the prevention and
care of shock. The primary objective is to keep
the victim lying down, warm and comfortable, so as to
facilitate blood circulation to the head and chest area. There are however,
two important exceptions to this procedure:
If the victim has
difficulty in breathing, elevate the upper part of his body.
If he has lost a great
deal of blood or if his injury is severe, elevate the lower part
of his body from 8-12 inches above the ground.
Should he have trouble
breathing when you attempt to elevate him, or if pain occurs,
or if he has a head injury, keep the victim in a prone
position. (See Bleeding)
DO NOT elevate legs if the
casualty has an un-splinted broken leg, head injury, or
abdominal injury. (See Fractures)
It is important that the shock patient
be warm and free from drafts. A blanket should be used to keep him
warm and prevent sweating. If the outside temperature is warm, little
covering will be necessary. During winter months, more covering will
be needed. Be careful if you use an electric
blanket, hot water bottle or heating pad. The victims skin will
not be able to withstand high heat and he himself will not feel the
burn, so keep the warming object at a temperature just above body
temperature. Test it on yourself for several seconds before placing it
on the victim. The main reason for covering him is to prevent the loss
of body heat, not to increase it.
Do not give the victim fluids if you
expect the doctor or ambulance within half an hour. Never give them if
the victim is unconscious or partly conscious, if he is nauseated, or
has penetrating abdominal injury or so is seriously injured as to
require immediate surgery. If you offer him water, be sure it is
neither cold nor hot but at room temperature. Avoid other fluids,
especially alcohol. Begin by giving him few sips at a time, an
increase the amount to half a glass at a time if he complains thrust
and can tolerate water without discomfort. If he vomits, discontinue
the water. If possible, add one-half level teaspoon of table salt and
one-half level teaspoon of baking soda to a quart of room temperature
water and administer at approximate 15 minutes interval.
Along with these first aid measures for
shock, treat the victim's injuries. Fractures should be splinted,
bleeding controlled, and above all he should be kept quite.
Stimulants such as ammonia or coffee
should never be given. Make certain that he gets medical assistance
within an hour after the accident.
The first rule of treatment in electrical injuries is to SAFELY remove the victim from continued
exposure. Give artificial respiration until natural breathing resumes.
Morphia acetate 30C in frequent doses is said to be very useful.
However, the patient will immediately need ambulance transportation to the hospital.
Acetic acid 30C, Arnica
200C,1M, Carbo Veg 200C,1M, Strontia Carb 30C and Veratrum Alb
200C,1M, Canadula 1M, Staphasgaria 1M, Opium 30C
Aconite Nap 200C,1M, Ignatia
200C,1M, Gelsemium 30C, Opium 30C, and
Rescue Remedy 30C to CM (Bach Flower).
Aconite Nap 200C,1M; Arnica Mont. 200C,1M,
Hypericum 200C,1M and Nat Sulph 200C,1M, Camphor Q, Carbo Veg 30C, 1M;
Lachesis 30C, Opium 30C, Verat Alb 30C,1M
Anaphylactic (allergic) Shock:
Acid 30c, Apis Mel 200c, 1M, Carbo Veg 30C, Opium 30C, Camphor 30C
Camphor Q, Naja T 30C, Crategus Ox Q, Arnica Q, Laurocerasus 30C &
Amyle Nit Q
Lycopodium 200C,1M, Antim Tart 200C,
conditions require immediate medical attention as such medicinal list
provided are for professional and not for laymen.